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DR. STEPHEN MATHEW KELSON D.D.S., M.D.
NPI 1417497389
Oral & Maxillofacial Surgery in Olympia, WA

Active since February 27, 2017Opted out of Medicare · through Nov 6, 2027
3624 ENSIGN RD NE STE A, OLYMPIA, WA 98506(360) 923-5412 Get Directions Write a Review

NPPES record last updated: October 3, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Dr. Stephen Mathew Kelson D.d.s., M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. STEPHEN MATHEW KELSON D.D.S., M.D. (NPI 1417497389) is an individual oral & maxillofacial surgery provider in Olympia, Washington, licensed in Washington (DE61354113) and active in the NPI registry since February 2017. He has opted out of Medicare through November 6, 2027.

NPPES Registry Identity

NPI1417497389
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. STEPHEN MATHEW KELSONCredential: D.D.S., M.D.
Location Address3624 ENSIGN RD NE STE AOlympia, WA 98506-5074
Mailing Address3624 Ensign Rd Ne Ste AOlympia, WA 98506-5074 · (360) 923-5412
Phone(360) 923-5412
Sole ProprietorYes
Enumeration DateFebruary 27, 2017
Last NPPES UpdateOctober 3, 2025
NPPES CertifiedOctober 3, 2025
✔ NPI 1417497389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in WA · DE61354113
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
3624 ENSIGN RD NE STE A, Olympia, WA 98506
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Stephen Mathew Kelson D.d.s., M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 6, 2025 through November 6, 2027.

Opt-Out Effective DateNovember 6, 2025
Opt-Out In Effect ThroughNovember 6, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephen Kelson's NPI number?

The NPI number for Stephen Kelson is 1417497389. It was assigned to this individual provider in the NPPES registry on February 27, 2017.

Where is Stephen Kelson located?

Stephen Kelson practices at 3624 Ensign Rd NE Ste A, Olympia, WA 98506. The listed phone number is (360) 923-5412.

What is Stephen Kelson's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Stephen Kelson enrolled in Medicare?

No. Stephen Kelson has opted out of Medicare through November 6, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Stephen Kelson was last updated on October 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.